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Jurnal Anestesi Perioperatif
Published by Universitas Padjadjaran
ISSN : 23377909     EISSN : 23388463     DOI : 10.15851/jap
Core Subject : Health, Education,
Education Health Professions
Jurnal Anestesi Perioperatif (JAP)/Perioperative Anesthesia Journal is to publish peer-reviewed original articles in clinical research relevant to anesthesia, critical care, case report, and others. This journal is published every 4 months with 9 articles (April, August, and December) by Department of Anesthesiology and Intensive Care Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung.
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Perbandingan Ketinggian Bantal 4,5 cm dan 9 cm terhadap Visualisasi Glotis Saat Laringoskopi di Rumah Sakit Dr. Hasan Sadikin Bandung Alam, Mohamad Deny Saeful; Suwarman, Suwarman; Redjeki, Ike Sri
Jurnal Anestesi Perioperatif Vol 5, No 3 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (675.71 KB) | DOI: 10.15851/jap.v5n3.1170

Abstract

Intubasi ialah prosedur baku mempertahankan patensi jalan napas dengan melihat secara langsung glotis melalui alat laringoskop. Visualisasi glotis akan lebih jelas pada saat tindakan laringoskopi langsung pada sniffing position. Ketinggian bantal yang berbeda akan memberikan visualisasi glotis yang berbeda pula. Penelitian ini merupakan penelitian eksperimen kuasi. Jumlah sampel penelitian 30 orang dengan 2 perlakuan berbeda, yaitu bantal dengan ketinggian 4,5 cm dan 9 cm. Pemilihan subjek penelitian dilakukan secara consecutive sampling dengan mengambil setiap subjek penelitian yang memenuhi kriteria inklusi. Subjek penelitian semua pasien yang menjalani operasi elektif dengan anestesi umum di Rumah Sakit Dr. Hasan Sadikin Bandung periode Juli 2015 yang memenuhi kriteria inklusi. Tujuan penelitian ini adalah mengetahui pengaruh pemakaian bantal 4,5 cm dibanding dengan bantal 9 cm terhadap nilai visualisasi glotis.  Visualisasi glotis dengan ketinggian bantal yang berbeda pada saat tindakan laringoskopi langsung dinilai menggunakan skala kelas Cormarck–Lehane (CL) dan skor percentage of glotic opening (POGO). Distribusi data dengan uji Shapiro Wilks, nilai p ditentukan menggunakan uji Wilcoxon dan bermakna jika p<0,05. Hasil penelitian ini menunjukkan bahwa nilai skala CL modifikasi kedua bantal berada pada kisaran  skala 1 hingga 2c (p=0,007). Skor  POGO bantal ketinggian 4,5 cm berada pada kisaran  20–100% dengan rata-rata 69,33±21,48%. Bantal ketinggian 9 cm skor POGO berada pada kisaran 30,00–80,00% dengan nilai rata-rata 58,333±15,33% (p=0,001). Simpulan, penggunaan bantal ketinggian 4,5 cm memberikan visualisasi glotis yang lebih baik saat laringoskopi langsung dibanding dengan  bantal ketinggian 9 cm.Comparison of 4.5 cm and 9 cm Pillow Height in Glottis Visualization on Laryngoscopy at Dr. Hasan Sadikin General HospitalIntubation is a standard procedure to maintain patency of the airway by  directly visualizing glottis with a laryngoscope. Visualization of the glottis will be clearer when direct laryngoscopy is performed in sniffing position. Different pillows heights will provide different visualization of the glottis. This study was a quasi-experimental study on 30 subjects who were divided into 2 experimental groups of 4.5 cm and 9 cm pillow heights. Subjects were sampled consecutively according to the inclusion and exclusion criteria. The population was all patients underwent elective surgery with general anesthesia at Dr. Hasan Sadikin Hospital Bandung during the period of July 2015. The purpose of this study was to determine the effect of using a pillow height of 4.5 cm when compared to 9 cm pillow height on glottis visualization based on an assessment using Cormarck–Lehane (CL) scale and percentage of glotic opening (POGO) scores. Data distribution was tested by Shapiro Wilks while the p values were determined using Wilcoxon test and was considered meaningful if p<0.05. The results showed that the value of modified CL–class scale for both pillow heights were in the range scale of 1 to 2c (p=0.007). The POGO scores of the 4.5 cm pillow height was in the range of 20–100% with an average percentage of 69.33±21.48%, while the POGO scores of the 9 cm pillow height were in the range of 30.00–80.00% with an average score of 58.333±15.33% (p=0.001). Therefore, the use of 4.5 cm pillow height gives better glottis visualization in direct laryngoscopy compared to the 9 cm pillow height.
Perbandingan Efektivitas antara Gabapentin 600 mg dan Gabapentin 900 mg Kombinasi dengan Ketorolak 30 mg/8 Jam sebagai Analgesia Pascabedah pada Total Abdominal Histerektomi dengan Anestesi Umum Camary, Mumya; Ihsan, Mhd.; Wijaya, Dadik Wahyu
Jurnal Anestesi Perioperatif Vol 4, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (537.288 KB)

Abstract

Gabapentin berkembang untuk penanganan nyeri akut pascabedah. Tujuan penelitian adalah menilai efektivitas gabapentin 600 mg dan 900 mg per oral kombinasi ketorolak 30 mg/8 jam intravena sebagai analgesia pascabedah pada total abdominal histerektomi dengan anestesi umum. Penelitian uji klinis acak tersamar ganda dilakukan di Rumah Sakit Umum Pusat H. Adam Malik Medan, RSUD Dr. Pirngadi Kota Medan, RS. Haji Medan, dan RS. Putri Hijau selama bulan Oktober 2015–Januari 2016. Terdapat 30 subjek penelitian, usia 18–60 tahun, status fisik American Society of Anesthesiologists (ASA) I–II yang menjalani operasi total abdominal histerektomi dengan anestesi umum. Subjek dibagi menjadi 3, yaitu kelompok A mendapat plasebo, kelompok B mendapat gabapentin 600 mg, dan kelompok C mendapat gabapentin 900 mg kombinasi ketorolak 30 mg/8 jam. Uji Kruskal Wallis digunakan untuk menilai efektivitas skor visual analogue scale (VAS) pascabedah serta uji chi-kuadrat untuk menilai kebutuhan rescue analgetia petidin selama 24 jam pascabedah. Pada perbandingan nilai VAS antara gabapentin 600 mg dan gabapentin 900 mg kombinasi dengan ketorolak 30 mg/8 jam tidak ditemukan perbedaan nilai yang signifikan antara kedua kelompok studi (p>0,05). Simpulan, efek gabapentin 600 mg dengan gabapentin 900 mg kombinasi ketorolak 30 mg/8 jam sebagai analgesia pascabedah tidak berbeda efektivitasnya dalam mengurangi nilai VAS dan kebutuhan rescue analgetia petidin selama 24 jam pascabedah.Kata kunci: Gabapentin, kebutuhan rescue analgetia, visual analogue scaleEffectiveness of Gabapentin 600 mg and 900 mg Combined Ketorolak as Postoperative Analgesics for Hysterectomy under General AnesthesiaAbstractGabapentin is developed recently to manage postoperative acute pain. The purpose of this study was to assess the efficacy of 600 mg and 900 mg oral gabapentin combined with 30 mg/8 hours intravenous ketorolak as the postoperative analgesics for total abdominal hysterectomy under general anesthesiaon visual analogue scale (VAS) and the need of pethidin in 24 hours postoperatively. A double blind controlled trial was performed to 30 subjects in H. Adam Malik Hospital Medan, Dr. Pirngadi Hospital Medan,Haji Hospital Medan,and Putri Hijau Hospital Medan. The study was performed during the period of October 2015 to January 2016. Patients were 18 to 60 years old with PS-ASA I–II who underwent total abdominal hysterectomy under general anesthesia. Subjects were divided into 3 groups.: Group A who received placebo, group B who received 600 mg of gabapentin, and group C who received 900 mg of gabapentin combined with 30 mg/8 hours ketorolak. The efficacy was assessed with post operative visual analogue scale (VAS) using Kruskal Wallis test, and the need for rescue analgesics pethidin in 24 hours postoperatively using chi-square test. The VAS scores of the group that received600 mg gabapentin and the group that received 900 mg gabapentin combined with 30 mg/hour ketorolak were not significantly different (p>0.05). In conclusion, the effects of 600 mg gabapentin and 900 mg gabapentin combined with 30 mg/8 hours ketorolak as the postoperative analgesics for total abdominal hysterectomy under general anesthesia are not different in terms of decreasing VAS score and the need for rescue analgesia pethidine in 24 hours postoperativelyKey words: Gabapentin, the need of analgesia rescue, visual analogue score DOI: 10.15851/jap.v4n3.898
Angka Mortalitas pasien Neonatus yang Menjalani Operasi berdasar atas Kenaikan Berat Badan Pascaoperasi yang Dirawat di Neonatal Intensive Care Unit (NICU) Komara, Asep Deden; Oktaliansah, Ezra; Rismawan, Budiana
Jurnal Anestesi Perioperatif Vol 5, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (276.698 KB) | DOI: 10.15851/jap.v5n2.1112

Abstract

Salah satu faktor risiko mortalitas pada neonatus yang menjalani operasi adalah regulasi cairan intraoperatif. Tujuan penelitian ini mengetahui angka mortalitas pada neonatus yang menjalani operasi berdasar atas kenaikan berat badan pascaoperasi yang dirawat di NICU. Metode penelitian adalah deskriptif dengan pendekatan retrospektif. Penelitian ini melibatkan 95 subjek penelitian, yaitu neonatus yang menjalani operasi dan dirawat di NICU RSHS Bandung selama tahun 2010‒2015. Data diambil dari rekam medis, pengambilan data mulai tanggal 1 Februari–29 Maret 2017.  Subjek dibagi tiga kelompok, yaitu neonatus yang telah menjalani prosedur operasi yang mengalami kenaikan berat badan pascaoperasi kurang 10% (I), neonatus yang menjalani prosedur operasi yang mengalami kenaikan berat badan 10‒20% (II), dan kelebihan berat badan ≥20% (III). Neonatus pacaoperasi dengan kenaikan berat badan  ≤10% sebanyak  46 pasien dan yang meninggal  sebanyak 10 pasien pada  kenaikan  berat badan 10‒20%  sebanyak 38 pasien, pasien yang meninggal sebanyak 23 pasien, angka mortalitasnya sebesar 60,5%, sedangkan  pada pasien dengan kenaikan berat badan sama dengan atau lebih dari 20% sebanyak 11 pasien atau 11,5% yang meninggal  sebanyak 10 pasien, angka mortalitasnya sebesar 90,9%. Simpulan angka mortalitas pasien neonatus yang menjalani operasi di RSHS dan pascaoperasi dirawat di NICU RSHS selama periode 2010–2015 adalah 45,3%. Kata kunci: Kenaikan berat badan, mortalitas, neonatus The Mortality Rate in Neonatal Patients which Underwent Surgical Procedures-Defined by the Escalation of Postoperative Weight and Those Who were Admitted in Neonatal Intensive Care Unit (NICU) One of the risk factors contributed to this number was the inappropriate management of intraoperative fluid resuscitation. The aim of this study is to understand the mortality rate in neonatal patients which underwent surgical procedures–defined by the escalation of postoperative weight and those who were admitted in NICU. The research method used in this study was a retrospective approach presented in a descriptive manner. The study involved 95 research subjects, which were neonatal patients which underwent surgical procedures and admitted in NICU RSHS Bandung from 2010‒2015. Data collection from Februari 1st–March 29th  2017. The research subjects were classified into three groups, neonatal patients which had escalation of weight postoperative less than 10% and underwent surgical procedure (I), neonatal patients which had escalation of weight postoperative ranging from 10‒20% and underwent surgical procedure (II), meanwhile consist of neonatal patients which had escalation of weight postoperative ≥20% and underwent surgical procedure (III). Result of the study showed there were 46 neonatal patients with 10% weight escalation and 10 out of 46 patients were ceased, meanwhile there were 38 neonatal patients with 10‒20% weight escalation and 23 out of 38 were ceased, and there were 11 neonatal patients with ≥20% weight escalation and 10 out of 11 were ceased. The conclusions of this study found a mortality rate of neonatal patients who underwent surgery and postoperative treated in  NICU RSHS during the period 2010 to 2015 is 45.3%. Key words: Weight gain, mortality, neonatal
Pengaruh Tes Elevasi Tungkai Secara Pasif terhadap Variasi Pletismograf untuk Penilaian Responsivitas Cairan pada Pasien yang Dilakukan Pembedahan dengan Anestesi Umum Susanto, Bahtiar; Pradian, Erwin; Bisri, Tatang
Jurnal Anestesi Perioperatif Vol 4, No 2 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Penilaian responsivitas terhadap cairan sangat berguna untuk optimalisasi cairan perioperatif. Variasi pletismograf (respiratory variations in the pulse oximetry plethysmographic waveform amplitude; ∆POP) dan elevasi tungkai secara pasif (passive leg raising; PLR) merupakan parameter dinamis yang akurat dalam menilai responsivitas terhadap cairan. Tujuan penelitian ini adalah menilai pengaruh elevasi tungkai secara pasif terhadap variasi pletismograf untuk menilai responsivitas terhadap cairan pada pasien setelah induksi anestesi umum. Penelitian ini merupakan uji klinis pada 30 pasien yang menjalani operasi dengan anestesi umum, usia 18–60 tahun, dan status fisik American society of anesthesiologist (ASA) I atau II pada bulan Februari–Maret 2015 di Instalasi Bedah Sentral Rumah Sakit Dr. Hasan Sadikin Bandung. Penelitian ini diuji dengan uji-t berpasangan, Wilcoxon, dan uji ANOVA. Setelah dilakukan induksi anestesi umum, variasi pletismograf dicatat sebelum, saat, dan sesudah elevasi tungkai secara pasif. Hasil penelitian menunjukkan efek elevasi tungkai secara pasif akan menurunkan variasi pletismograf. Penurunan variasi pletismograf yang signifikan pada responden yang memiliki responsivitas terhadap cairan 6/30 dengan variasi pletismograf >13% sebelum dilakukan elevasi tungkai secara pasif. Perbedaan ini bermakna secara statistik (p<0,05). Elevasi tungkai secara pasif akan menurunkan variasi pletismograf yang dapat digunakan untuk menilai responsivitas terhadap cairan pada pasien yang menjalani operasi dengan anestesi umum.Kata kunci: Anestesi umum, elevasi tungkai secara pasif, responsivitas terhadap cairan, variasi pletismografEffect of Passive Leg Raising Test on Respiratory Variations in Pulse Oximetry Plethysmographic Waveform in Assessing Fluid Responsiveness of Surgery Patients under General AnesthesiaFluid responsiveness assessments have shown to be an important matter in perioperative fluid optimization. Respiratory variations in pulse oximetry plethysmographic waveform amplitude (∆POP) and passive leg raising have been shown as promising indicators due to the ability to predict fluid responsiveness. The aim of this study was to assess the effect of passive leg raising (PLR) on ∆POP to predict fluid responsiveness in mechanically ventilated patients after induction of general anesthesia. This was a trialon 30 patients referred for surgery under general anesthesia, aged 18–60 years and ASA physical status I or II, during the period of February–March 2015 at the Central Surgical Installation of Dr. Hasan Sadikin General Hospital Bandung. Patients were studied immediately after the induction of general anesthesia. This trial use the paired t test, Wilcoxon test, and ANOVA for statistical analysis. Vital signs and ∆POP were recorded at baseline, before, and after PLR. PLR induced changes in ∆POP with a ∆POP greater than 13% compared to the initial PLR allowed discrimination between responders and nonresponders to 6/30. There was a significant decrease in ∆POP in responders when compared to the nonresponders(p<0.05). ∆POP can be reduced by PLR and fluid responsiveness can be predicted noninvasively in mechanically ventilated patients during general anesthesia.Key words: Fluid responsiveness, general anesthesia, passive leg raising, respiratory variations in the pulse oximetry plethysmographic waveform amplitude DOI: 10.15851/jap.v4n2.821
Lactate Clearance sebagai Prediktor Mortalitas pada Pasien Sepsis Berat dan Syok Septik di Intesive Care Unit Rumah Sakit Dr. Hasan Sadikin Bandung Kurniawan, Muhammad Budi; Pradian, Erwin; Nawawi, Muthalib
Jurnal Anestesi Perioperatif Vol 5, No 1 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (599.202 KB) | DOI: 10.15851/jap.v5n1.1003

Abstract

Tingkat mortalitas pasien sepsis berat di Intensive Care Unit (ICU) dihitung dengan menggunakan skor acute physiology and chronic health evaluation (APACHE II), namun memerlukan pemeriksaan yang banyak serta kompleks. Penurunan lactate clearance berhubungan dengan kondisi mikrosirkulasi yang buruk. Lactate clearance diharapkan memiliki kemampuan untuk menentukan tingkat mortalitas pasien sepsis berat dan syok septik. Penelitian ini bertujuan mengetahui kegunaan lactate clearance sebagai prediktor mortalitas pasien sepsis berat dan syok sepsis di ICU Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung yang lebih mudah dan efisien. Penelitian ini dilakukan secara prospektif observasional cohort terhadap 51 orang. Penelitian dilakukan di ICU RSHS Bandung dari bulan September–November 2015 dengan uji Mann Whitney pada data numerik dan Exact Fisher pada data kategorik. Setiap subjek penelitian diperiksa nilai laktat secara berkelanjutan pada jam pertama (H0) dan jam ke-24, kemudian dihitung nilai lactate clearance dengan rumus laktat awal-laktat serial/laktat awal x 100%. Subjek dibagi menjadi 2 kelompok berdasar atas nilai lactate clearance rendah (<40%) dan nilai lactate clearance tinggi (>40%). Hasil penelitian menunujukkan bahwa lactate clearance memiliki sensisitivitas 100%; spesifisitas 88,4%; nilai duga positif 89,2%; nilai duga negatif 100%; rasio kemungkinan positif 86,6%; rasio kemungkinan negatif 0 dan akurasi 94,11%. Simpulan penilitian adalah lactate clearance dapat digunakan sebagai prediktor mortalitas pada pasien sepsis berat dan syok septik di ICU RSHS Bandung.Kata kunci: Lactate clearance, mortalitas, sepsisLactate Clearance as Mortality Predictor in Severe Sepsis and Septic Shock Patient in Intensive Care Unit Dr. Hasan Sadikin General Hospital Bandung Mortality incidence predictor used for sepsis and shock septic in Intensive Care Unit (ICU) were measured using Acute Physiology and Chronic Health Evaluation (APACHE) II score, which needs many complex examinations. The purpose of this study was to examine lactate clearance as an alternative mortality predictor. Decreased percentage of lactate clearance is related to poor perfusion in microcirculation which leads to the possibility that lactate clearance can be used to predict mortality incidence in severe sepsis and shock septic patients in the ICU of Dr. Hasan Sadikin General Hospital Bandung. This was a prospective observational cohort study involving 51 patients who met sepsis and shock septic criteria during the period of September to November 2015. Lactate was examined continuously in all patients at first hour (H0) and H24 and then the lactate clearance value was measured using the following formula: lactate initial–lactate delayed/lactate initial x100%. Subjects were divided into two groups according to the low lactate clearance(<40%) and high lactate clearance (>40%). The Mann Whitney test was used for numeric data and exact Fisher test was used for categorical data. Results showed that the lactate clearance had a sensitivity of 100%, specificity of 88.4%, positive predictive value of 89.2%, negative predictive value of 100%, likelihood ratio positive of 86.6%, likelihood ratio negative of 0% and accuracy of 94.11%. Thus, lactate clearance can be used to predict mortality incidence in severe sepsis and shock septic patients.Key words: Lactate clearance, mortality, sepsis 
Efek Kombinasi Epidural dan Obat Anti-inflamasi Nonsteroid terhadap Nyeri dan Kadar Prostaglandin Gaus, Syafruddin; Patellongi, Ilham Jaya; Budianto, Jeffri; Ahmad, Muh. Ramli
Jurnal Anestesi Perioperatif Vol 6, No 1 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (745.393 KB) | DOI: 10.15851/jap.v6n1.1288

Abstract

Kombinasi analgesia epidural (AE) dengan obat anti-inflamasi nonsteroid (OAINS) seperti ketorolak dan parecoxib sebagai analgesia preventif diperlukan untuk mengurangi nyeri pascabedah. Penelitian ini bertujuan mengetahui efek OAINS sebagai analgesia preventif pada pascabedah laparatomi ginekologi berdasar atas perubahan kadar prostaglandin-E2 (PGE2) dan intensitas nyeri. Penelitian bersifat eksperimental acak tersamar ganda dengan jumlah sampel 60 pasien. Penelitian dilakukan di RSUP Dr. Wahidin Sudirohusodo Makasar bulan Maret–Juni 2017. status fisik 1 dan 2 menjalani laparatomi ginekologi dengan anestesi epidural. Subjek dibagi 3 kelompok, yaitu ketorolak (K) 0,5 mg/kgBB intravena, parecoxib (P) 40 mg intravena, dan plasebo (N) NaCl 0,9% 2 mL yang diberikan 30 menit sebelum insisi, 8 jam, dan 16 jam pascabedah. Data dianalisis dengan uji one-way ANOVA, uji Exact Fischer, uji Mann-Whitney U pada batas kemaknaan α=5%. NRS=1 pada kelompok K dan P saat insisi hingga 16 jam pascabedah dan berbeda signifikan (p<0,05) dengan kelompok N; 15% mengalami peningkatan intensitas nyeri (NRS=2) 8 jam pascabedah. Kadar PGE2 pada plasebo paling tinggi (439,7±35,1; 481,7±60,1; 565,1±58,7), berbeda signifikan (p<0,05) dengan parecoxib (230,7±19,5; 221,4±16,4; 201,1±18,1). Ketorolak berada di antara keduanya. Simpulan, parecoxib dan ketorolak sebagai analgesia preventif yang dikombinasi AE pada pasien bedah laparatomi ginekologi dapat menekan nyeri dan mengurangi produksi PGE2. Efek parecoxib lebih kuat daripada ketorolak mengurangi produksi PGE2, tetapi sama kuatnya dalam menekan intensitas nyeri pascabedah laparatomi ginekologi.Kata kunci: Analgesia epidural, ketorolak, laparatomi ginekologi, parecoxib, PGE2
Perbandingan Waktu Awitan dan Lama Kerja Kombinasi Bupivakain 0,5% dan Lidokain 2% dengan Bupivakain 0,5% pada Blokade Infraklavikular untuk Operasi Lengan Bawah Destiara, Andy Pawana; Yadi, Dedi Fitri; Kadarsah, Rudi Kurniadi
Jurnal Anestesi Perioperatif Vol 4, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Penggunaan kombinasi obat anestesi lokal bupivakain dan lidokain dapat menghasilkan waktu awitan yang cepat dan lama kerja yang panjang. Penelitian ini bertujuan membandingkan waktu awitan dan lama kerja kombinasi bupivakain 0,5% dan lidokain 2% dengan bupivakain 0,5% pada blokade infraklavikular untuk pembedahan lengan bawah. Penelitian menggunakan uji klinis acak terkontrol buta ganda terhadap 36 pasien dewasa usia 18–60 tahun yang menjalani pembedahan lengan bawah dan dilakukan blokade infraklavikular dengan panduan nerve stimulator di Rumah Sakit Dr. Hasan Sadikin Bandung selama periode April–Juni 2015. Pasien dibagi dalam dua kelompok, kelompok bupivakain dan lidokain (BL) dan bupivakain (B). Analisis stastistik menggunakan student’s t-test, chi-square, Eksak Fisher, Kolmogorov Smirnov dan Mann-Whitney U-test. Hasil penelitian didapatkan waktu awitan blokade sensorik dan motorik pada kelompok BL, yaitu 7,1±2 menit dan 10,9±5,3 menit, pada kelompok B, yaitu 19,8±4,5 menit dan 29±7,7 menit. Lama kerja blokade sensorik dan motorik pada kelompok BL, yaitu 540,9±195,1 menit dan 445,6±158,9 menit, pada kelompok B, yaitu 837,6±376,6 menit dan 653,9±304,3 menit. Simpulan, kombinasi bupivakain 0,5% dan lidokain 2% menghasilkan awitan blokade sensorik serta motorik lebih cepat dan lama kerja yang lebih singkat dibanding dengan bupivakain 0,5%.Kata kunci: Blokade infraklavikular, kombinasi bupivakain-lidokain, bupivakain, lama kerja blokade, waktu awitan blokade Comparison of Onset and Duration of Action between 0.5% Bupivacaine and 2% Lidocaine Combination and 0.5% Bupivacaine on Infraclavicular Block for Forearm SurgeryAbstractThe combination of local anesthetic drugs bupivacaine and lidocaine can produce rapid onset and long duration of action. The purpose of this study was to compare the onset and duration of action between 0.5% bupivacaine and 2% lidocaine combination and 0.5% bupivacaine on infraclavicular block for forearm surgery. This study was conducted using a randomized double blind controlled clinical trial on 36 adult patients aged 18–60 years who underwent forearm surgery under infraclavicular block using nerve stimulator guidance in Dr. Hasan Sadikin General Hospital between the period of April to June 2015. Patients were divided into two groups: patients in bupivacaine and lidocaine (BL) group and bupivacaine (B)group. The statistical analysis were performed using the student’s t-test, chi-square, Fisher’s Exact, Kolmogorov Smirnov, and Mann-Whitney U-test. The onsets of sensory and motor blocks in BL group were 7.1±2 min and 10.9±5.3 min, repectively and B group were 19.8±4.5 min and 29±7.7 min, respectively. The durations of sensory and motor blocks in BL group were 540.9±195.1 min and 445.6±158.9 min and B group were 837.6±376.6 min and 653.9±304.3 min. This study reveals that the combination of 0.5% bupivacaine and 2% lidocaine in infraclavikular block had a faster onset of sensory and motor blocks compared to 0.5% bupivacaine and a shorter duration of action compared to 0.5% bupivacaine.Key words: Bupivacaine, combination of bupivacaine–lidocain, duration of block, infraclavicular block, onset of block DOI: 10.15851/jap.v4n3.902
Perbandingan antara Uji Mallampati Modifikasi dan Mallampati Ekstensi Sebagai Prediktor Kesulitan Intubasi Endotrakeal di Rumah Sakit Dr. Hasan Sadikin Bandung Swasono, Girindro Andi; Suwarman, Suwarman; Kadarsah, Rudi Kurniadi
Jurnal Anestesi Perioperatif Vol 5, No 3 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (732.566 KB) | DOI: 10.15851/jap.v5n3.1168

Abstract

Evaluasi potensi intubasi sulit preoperatif sangat penting. Metode standar untuk menilai potensi intubasi sulit adalah metode Mallampati Modifikasi. Metode Mallampati Ekstensi merupakan metode Mallampati Modifikasi dengan ekstensi titik kranioservikal sehingga derajat bukaan mulut lebih lebar dan saluran napas terlihat lebih baik. Tujuan penelitian ini adalah mengetahui ketepatan penilaian Mallampati Ekstensi dibanding dengan Mallampati Modifikasi sebagai prediktor dalam menilai kesulitan intubasi endotrakeal menggunakan laringoskop Macintosh langsung berdasar atas uji Cormack Lehane. Desain penelitian ini adalah observasional analitik dengan metode potong lintang dan uji diagnostik chi square. Hasil penelitian terhadap 382 subjek pada bulan September 2016 hingga bulan Desember 2016 di Rumah Sakit Dr. Hasan Sadikin Bandung didapatkan jenis kelamin perempuan 69,9% dengan median usia 42 tahun. Frekuensi nilai uji Mallampati Ekstensi lebih banyak pada kelas yang lebih rendah dan berbeda secara signifikan dibanding dengan uji Mallampati Modifikasi. Kesesuaian penilaian kelas uji Mallampati Ekstensi dengan Cormack Lehane terdapat pada 318 subjek. Simpulan, uji Mallampati Ekstensi lebih baik daripada uji Mallampati Modifikasi sebagai prediktor menilai kesulitan intubasi endotrakeal menggunakan laringoskop langsung.Comparison between Modified Mallampati Test and Extended Mallampati Test as Predictor of Difficult Endotracheal Intubationat Dr. Hasan Sadikin Hospital BandungPreoperative evaluation of potentially difficult intubation is very important. The standard method for assessing potentially difficult intubation is the Modified Mallampati method. Extended Mallampati method is a Modified Mallampati method with cranioservical extension point that the degree of mouth opening is wider and airway becomes more visible. The purpose of this study was to determine the accuracy of the Extended Mallampati test compared to the Modified Mallampati test as predictors in assessing the difficulty of endotracheal intubation using direct Macintosh laryngoscope based on Cormack Lehane grading. This was a cross-sectional observational analytical study using chi square diagnostic test involving 382 subjects at Dr. Hasan Sadikin Bandung Hospital during the period of September 2016 to December 2016 with 69.9% women and  median age of 42 years. The frequency of the Mallampati Extension test scores was higher in the lower classes, which was significantly different from the results of the Modified Mallampati test. Better appropriateness of the Mallampati Extension test result with Cormack Lehane grading was found in 318 subjects. In conclusion, the Extended Mallampati test is better than Modified Mallampati test when it is used as a predictor in assessing difficult endotracheal intubation using direct laryngoscopy (Cormack Lehane test).  
Perbandingan Efek Pemberian Cairan Kristaloid Sebelum Tindakan Anestesi Spinal (Preload) dan Sesaat Setelah Anestesi Spinal (Coload) terhadap Kejadian Hipotensi Maternal pada Seksio Sesarea Fikran, Zaki; Tavianto, Doddy; Maskoen, Tinni T.
Jurnal Anestesi Perioperatif Vol 4, No 2 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Pemberian cairan secara preload sebagai profilaksis sebelum anestesi spinal telah menjadi prosedur rutin untuk mencegah hipotensi ibu selama tindakan seksio sesarea. Tidak seperti koloid, waktu pemberian cairan kristaloid merupakan hal penting karena singkatnya waktu cairan kristaloid berada di ruang intravaskular. Penelitian ini bertujuan mengetahui pengaruh waktu pemberian cairan kristaloid terutama Ringerfundin yang lebih baik antara preload dibanding dengan coload dalam mencegah hipotensi maternal selama anestesi spinal pada seksio sesarea. Penelitian dilakukan di Central Operating Theatre (COT) Rumah Sakit Dr. Hasan Sadikin Bandung periode Juni−Juli 2015 dengan uji klinis acak tersamar tunggal terhadap 36 pasien yang menjalani seksio sesarea dengan status fisik American Society of Anesthesiologist (ASA) II. Kejadian hipotensi dinilai setelah pemberian anestesi spinal sampai bayi lahir. Data hasil penelitian dianalisis dengan uji-t, Uji Mann-Whitney, dan uji chi-kuadrat dengan nilai p<0,05 dianggap bermakna. Insidens hipotensi lebih rendah pada kelompok kristaloid coload dibanding dengan kelompok kristaloid preload (44,4% vs 77,8%; p=0,040). Simpulan penelitian ini menunjukkan bahwa pemberian cairan kristaloid secara coload lebih efektif daripada preload untuk pencegahan hipotensi maternal setelah anestesi spinal pada seksio sesarea.Kata kunci: Anestesi spinal, hipotensi, kristaloid, seksio sesareaComparison of the Effect of Crystalloids Fluid Provision Before Spinal Anesthesia (Preload) and Shortly after Spinal Anesthesia (Co-load) on Maternal Hypotension Incidence in Caesarean DeliveryProphylactic fluid as a preload before spinal anesthesia has been a routine procedure to prevent maternal hypotension during cesarean delivery. Unlike colloid, timing of infusion of crystalloid may be important because it has short linger time in the intravascular space. This study aimed to compare the effect of the timing of administration of crystalloid, especially Ringerfundin, which is more effective between preload and co-load in preventing maternal hypotension during spinal anesthesia for cesarean section. This study was performed at the Central Operating Theatre (COT) of Dr. Hasan Sadikin General Hospital Bandung in June−July 2015 using the single blind randomized controlled trial method on 36 patients who underwent caesarean section with American Society of Anesthesiologist (ASA) II physical status. The incidence of hypotension was observed starting from the time the spinal anesthesia was performed to the time when the baby was born. Data were analyzed statistically using t-test, Mann Whitney test, and chi-square test where a p value of <0.05 considered significant. The incidence of hypotension was lower in the co-load group when compared to the preload group (44.4% vs. 77.8%, p value=0.040). In conclusion, the use of crystalloids for cesarean delivery in co-loading manner is more effective than preloading for the prevention of maternal hypotension after spinal anesthesia.Key words: Cesarean delivery, crystalloid, hypotension, spinal anesthesia DOI: 10.15851/jap.v4n2.818
Gambaran Pengetahuan Klinisi Ruang Rawat Intensif mengenai Ventilator Associated Pneumonia (VAP) Bundle di Ruang Rawat Intensif RSUP Dr. Hasan Sadikin Bandung Sadli, M. Fajar; Tavianto, Doddy; Redjeki, Ike Sri
Jurnal Anestesi Perioperatif Vol 5, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (636.643 KB) | DOI: 10.15851/jap.v5n2.1108

Abstract

Ventilator associated pneumonia (VAP) merupakan infeksi yang terjadi pada pasien yang terintubasi ≥48 jam di ruang rawat intensif. Penanganan VAP merupakan tantangan utama akibat morbiditas dan mortalitas yang tinggi.Ventilator associated pneumonia bundle (VAPb) telah terbukti dapat menurunkan angka kejadian VAP sehingga pengetahuan dokter dan perawat mengenai VAPb menentukan keberhasilan pencegahan VAP di ruang rawat intensif. Tujuan penelitian ini mengetahui pengetahuan dokter dan perawat mengenai VAPb di ruang rawat intensif RSUP Dr. Hasan Sadikin Bandung. Data diambil dari bulan November–Desember 2016. Penelitian deskriptif dengan desain potong lintang ini menggambarkan pengetahuan mengenai VAPb dari dokter residen Departemen Anestesi dan Terapi Intensif dan perawat di ruang rawat intensif RSUP Dr. Hasan Sadikin Bandung. Responden terdiri atas 79 dokter dan 88 perawat. Tingkat pengetahuan VAPb diuji menggunakan 20 pertanyaan kuesioner. Responden perawat terbanyak berjenis kelamin perempuan (74%), berusia ≥30 tahun (92%), status pendidikan diploma III (65%), lama kerja >5 tahun (76%), dan bekerja di Intensive Care Unit (ICU) (32%). Responden dokter terbanyak berjenis kelamin laki-laki (71%), berusia ≥30 tahun (83%), dan telah menyelesaikan stase ICU (61%). Simpulan, nilai kuesioner perawat dan dokter rata-rata berturut-turut 73,63 dan 73,16. Kata kunci: Klinisi ruang rawat intensif, tingkat pengetahuan, ventilator associated pneumonoia bundle Description of Intensive Care Clinician Knowledge about Ventilator Associated Pneumonia (VAP) Bundle in the Intensive Care Unit of  Dr. Hasan Sadikin Hospital BandungVentilator associated pneumonia (VAP) is an infection that occurs in patients who are intubated ≥48 hours in intensive care. Management VAP is a major challenge due to the high morbidity and mortality. Ventilator associated pneumonia bundle (VAPb) has been shown to reduce the incidence of VAP, so knowledge of doctors and nurses about VAPb determine the success of preventing VAP in intensive care. This study aims to know the description of intensive care clinician knowledge about ventilator associated pneumonia bundle in the intensive care of Dr. Hasan Sadikin General Hospital Bandung. Data were collected from November–December 2016. Descriptive study with cross-sectional design depicts VAPb knowledge of resident physicians Department of Anesthesia and Intensive Therapy and nurses in the Intensive Care Department of Dr. Hasan Sadikin Hospital. Respondents consisted of 79 doctors and 88 nurses. The level of knowledge VAPb tested using a 20 question questionnaire. Most nurse respondents were female (74%), aged ≥30 years (92%), educational status diploma III (65%), length of employment >5 years (76%), and work in Intensive Care Unit (ICU) (32%). Most physician respondents were male sex (71%), aged ≥30 years (83%), and had completed stase ICU (61%). In conclution, the mean value of the questionnaire nurses and doctors respectively 73.63 and 73.16. Key words: Intensive care clinician, level of knowledge, ventilator associated pneumonoia bundle

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